Smokes, mirrors and a happy new year

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Adjunct Professor John G Kelly, AM

John joined the Heart Foundation in August 2016. Previous to that, he led sector reform for aged care as CEO of Aged and Community Services Australia. He has extensive clinical, management and consulting background in the health sector, including previous careers in law and in cardiac nursing and current academic appointments with the Sydney Nursing School and the University of Technology, Sydney.

Today in Australia more than 2.7 million Australians will light up a cigarette and inhale. You may be one of them. You may also be one of the thousands who began the new year with a firm resolve to quit the habit.

If so, there is good news and not-so-good (and then more good).

The good.

First, Australia is a great place to give up smoking. We’re world leaders in tobacco control. Initiatives such as taxing tobacco products, bans on advertising, and legislating smoke-free areas (many Australians still remember smoking at work and in restaurants and hotels) have helped halve the proportion of tobacco users in the past 25 years. Our ground-breaking plain packaging laws have now been adopted in over 18 countries including Britain and France.

The not-so-good.

Despite this (and whatever you’ve been told), tobacco use remains the leading cause of preventable death in Australia. As a tobacco user you can expect to die on average 10 years earlier than if you had never smoked. Even “light” smoking (fewer than 14 a day) doubles your risk of dying prematurely. And for every person who dies too young because of tobacco, another 30 users can expect to suffer a smoking-related disease.

When it comes to heart health, 12 per cent of deaths due to cardiovascular disease are directly attributable to the artery-clogging effects of tobacco. Smokers have more heart attacks and strokes than non-smokers ­­– and they have them much younger.

And if you’re someone who likes playing the odds, consider this: up to two-thirds of current smokers will die from a tobacco-related disease if they don’t quit. This is a lot worse than the outdated 50/50 chance that is still widely quoted. As a smoker, the odds are now firmly stacked against you. (And, no, the Heart Foundation does not back e-cigarettes as a safe alternative. There is no convincing evidence it will help you quit, and growing concerns that vaping comes with its own health risks – more on this soon.)

In a recent article in the Medical Journal of Australia, ANU epidemiologist Emily Banks points to a paradox. While everyone knows smoking is terrible, she says, we cling to the illusion that the problem has somehow been “solved”. Lulled by the enviable advances of recent decades (24 per cent of adults in Australia reported using tobacco daily in 1991; by 2016 that figure was just over 12 per cent), we, and our governments, have become complacent.

In truth, the downward momentum has slowed almost to the point of stalling. One notable area where we are now lagging is in mass media education campaigns. Despite clear evidence that anti-tobacco campaigns work – and the success of the recent Indigenous tobacco campaign, Don’t Make Smokes Your Story – there has been no major mainstream tobacco education campaign since 2012.

Also, giving up is hard. Most smokers will try and fail and try again – often several times before they finally kick the habit.

A bit more good

So, on the hard days – the ones where tobacco seems to be winning – it’s important to remember this. Persistence pays. And quitting at any age is beneficial (the sooner the better). Giving up is not glamourous. It’s not easy. Often, it’s not quick. But it is doable. Tens of thousands of Australians do it every year. The benefits start almost immediately. And you don’t have to do it alone.

Seek help. From your GP, the Quitline 137848, or from organisations such as the Heart Foundation and Cancer Council,

Bear in mind too that helping someone else to quit is a profound gift. As Emily Banks points out, there is a good chance that in supporting someone to kick the habit you are saving a life. It could be your partner’s, your father’s, your daughter’s, a friend’s. Possibly your own because breathing other people’s smoke can kill you too. The sooner you start – giving up smoking or helping someone else to quit - the better the odds. That seems like a resolution worth sticking to.